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General NPI Number Information
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NPI Number | 1316698756
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Entity Type | Organization
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Legal Business Name | TESTING CENTERS OF AMERICA LLC
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 300 N MAIN ST
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City | JACKSONVILLE
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State | IL
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Zip | 62650-2021
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Country | US
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Telephone | 630-518-0271
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Fax |
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Provider Business Mailing Address
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Address Line | 1312 ROYAL SAINT GEORGE DR
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City | NAPERVILLE
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State | IL
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Zip | 60563-2317
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Country | US
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Telephone | 630-518-0271
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PRANAY PANDYA
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Credential |
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Telephone | 630-518-0271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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